Cassava (also known as manioc or yucca) is a vegetable that grows in tropical countries. It is an important food source for an estimated 600 million people worldwide, especially in developing countries. Cassava is an important food during drought or famine and is believed to provide more than a third of caloric content in Africa. Cassava is a staple in the humid and subhumid areas of tropical Africa.

Cassava contains high levels of cyanic glycosides. These toxic substances are removed during processing to prevent them from being converted to hydrogen cyanide, which may cause diseases and sometimes death. Researchers are working to create a form of cassava that has reduced levels of cyanic glycosides, as well as higher nutritional value, as a way to reduce malnutrition and chronic illness in developing countries.

At this time, there are no high-quality studies that support the use of cassava for any medical condition. Some research suggests that cassava salt solutions may help rehydrate children who suffer from acute diarrhea.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

Cassava salt solutions have been shown to help rehydrate children who are suffering from mild dehydration caused by acute diarrhea. These solutions are easy to make, readily available, and cheaper than the World Health Organization/Oral Rehydration Solution (WHO/ORS). However, more well-designed studies are needed before firm conclusions can be made.

C

Manioc flour, which comes from cassava, has been studied for its potential anti-inflammatory effects. However, there is a lack of evidence supporting cassava's use for this condition. Further research is needed.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

To treat dehydration, five teaspoons of fried manioc from cassava and one teaspoon of salt have been added to 600 milliliters of water and taken by mouth. About 75 milliliters of manioc salt solution per kilogram has been taken by mouth in a cup or a spoon over four hours. A dose of 50-100 milliliters of manioc fluid per bowel movement has been given to children younger than two years old to take by mouth. A dose of 100-200 milliliters of manioc fluid per bowel movement has been given to children two years old and older to take by mouth. A cassava salt solution has been given to male infants aged 4-24 months to take by mouth.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid if allergic or sensitive to cassava, its parts, or members of the Euphorbiaceae family. There is 23% cross-reactivity between cassava and latex. Skin prick tests have shown a 5.8% sensitization to yucca (cassava is the root vegetable of yucca).

Side Effects and Warnings

Cassava is considered safe when taken in small amounts for short periods of time by people who are not malnourished: about 30 grams daily in adults or five teaspoons of fried manioc (made from cassava) in children several times daily for less than two weeks. The potentially toxic cyanic glycoside content of cassava may be reduced by softening, soaking, rinsing, or baking.

Cassava is likely safe in pregnant and breastfeeding women who are not allergic and who take it in amounts that are generally found in foods. Levels higher than those normally found in the diet are not recommended due to the potentially toxic levels of cyanic glycosides. Cassava also contains goitrogens, which may cause congenital hypothyroidism and may be passed to babies during breastfeeding. Additionally, pregnancy may worsen a woman's preexisting iodine deficiency. Exposure to the thiocyanate from cassava may affect thyroid hormones and lead to changes in the baby's brain structure, which could possibly cause autism, according to one study. More research is needed.

Avoid if allergic or sensitive to cassava, its parts, or members of the Euphorbiaceae family. There is 23% cross-reactivity between cassava and latex. Skin prick tests have shown a 5.8% sensitization to yucca (cassava is the root vegetable of yucca).

Avoid using when the absence of cyanic glycosides in the cassava product cannot be determined. Potentially toxic levels of cyanic glycosides are naturally found in cassava, and if they are not removed, they may convert to hydrogen cyanide, cyanohydrins, and thiocyanates, which may cause death and disease, especially in people who have low-protein diets.

Avoid in people who have iodine deficiency, malnutrition, or thyroid deficiency, or who are eating a low-protein diet.

Use cautiously when the cassava contains 50-100 parts per million of cyanogenic content and is taken for extended periods of time by otherwise healthy adults.

Use cautiously in people who are taking birth control by mouth (oral contraceptives) or chondroitin.

Cassava may increase the risk of bleeding. Caution is advised in people with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Cassava is likely safe in pregnant and breastfeeding women who are not allergic and who take it in amounts that are generally found in foods. Levels higher than those normally found in the diet are not recommended due to the potentially toxic levels of cyanic glycosides. Cassava also contains goitrogens, which may cause congenital hypothyroidism and may be passed to babies during breastfeeding. Additionally, pregnancy may worsen a woman's preexisting iodine deficiency. Exposure to the thiocyanate from cassava may affect thyroid hormones and lead to changes in the baby's brain structure, which could possibly cause autism, according to one study. More research is needed.

Cassava may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Cassava may also interact with contraceptives (birth control), iodine, and thyroid agents.

Interactions with Herbs and Dietary Supplements

Cassava may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Cassava may also interact with chondroitin, hormonal herbs and supplements, iodine, and thyroid herbs and supplements.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.